脑核磁共振成像和脑干听觉诱发电位对新生儿胆红素脑病诊断价值的meta分析

MRI vs BAEP in diagnosis of Kernicterus:a systematic review and meta-analysis

目的应用诊断性meta分析的方法探讨脑核磁共振成像(MRI)和脑干听觉诱发电位(BAEP)对于新生儿胆红素脑病的诊断价值。方法计算机检索中国知网、万方数据知识服务平台、维普资讯中文期刊服务平台、PubMed、The Cochrane Library、Embase等数据库,搜集MRI和BAEP诊断新生儿胆红素脑病的相关文献,语种包括中文和英文。采用Stata 12.0软件绘制森林图和综合受试者工作特征曲线(SROC)并进行综合分析。结果MRI组的合并敏感度为0.84(95%CI,0.52~0.96),特异度为0.79(95%CI,0.40~0.95),曲线下面积(AUC)为0.89;BAEP组的合并敏感度为0.80(95%CI,0.70~0.86),特异度为0.72(95%CI,0.47~0.88),曲线下面积(AUC)为0.82。结论脑核磁共振成像和脑干听觉诱发电位对于新生儿胆红素脑病的诊断均有重要的参考价值。

Objective To investigate the diagnostic value of magnetic resonance imaging(MRI)and brainstem auditory evoked potentials(BAEP)in neonatal bilirubin encephalopathy by means of diagnostic meta analysis.Methods Databases such as CNKI,Wanfang,VIP,PubMed,the Cochrane Library,Embase and other databases were searched to collect MRI and BAEP related literature on the diagnosis of neonatal bilirubin encephalopathy,including Chinese and English.Stata 12.0 software was used to draw forest maps and synthesize the working characteristic curves(SROC)of the subjects and to carry out a comprehensive analysis.Results The combined sensitivity of MRI Group was 0.84(95%CI,0.52-0.96),the specificity was 0.79(95%CI,0.40-0.95),the area under the curve(AUC)is 0.89;The combined sensitivity of BAEP Group is 0.80(95%CI,0.70-0.86),the specificity is 0.72(95%CI,0.47-0.88),and the area under the curve(AUC)was 0.82.Conclusion Magnetic resonance imaging and brainstem auditory evoked potentials both have certain reference value for the diagnosis of neonatal bilirubin encephalopathy.